Field of the Invention
The present invention relates to the field of endoscopic surgery, and more precisely the methods and systems used to assist the practitioner in these surgical operations.
State of the Art
Endoscopic surgery requires the visualization of anatomical structures depicted in non-usual manner along a viewing axis that is different from the one used in conventional open surgery. In particular, the image is very often in two dimensions only, and the image is magnified which means that reference marks are modified, etc. In addition, control over instruments is often the reverse of their real movement in space, which imposes additional factors to be taken into account by the practitioner, compared with open surgery.
On this account, the performing of endoscopic operations requires specific learning, combining a procedural learning component, i.e. relating to hand coordination, with a visual learning component i.e. relating to coordination between actual procedure and the patient. This learning is necessary both for a practitioner with no particular surgical experience, and for a surgeon qualified in conventional open surgery but who has no experience in endoscopic surgery. This is notably the case for the learning of laparoscopic surgery as compared with laparotomy.
This learning is long and complex. First, a theoretical learning phase is required to learn to integrate the theoretical positioning of the instruments with respect to the organs, in relation to the surgical task to be performed. The different surgery protocols corresponding to different surgical operations must also be learnt. A surgery protocol is defined as a succession of surgical steps for the purpose of carrying out the corresponding surgical operation. A surgical step comprises one or more elementary surgical tasks conducted in a region of an operative site to obtain the surgical result corresponding to one of the steps in performing the surgical operation.
The second phase is the practical learning phase. This consists of becoming familiar with the endoscopic approach to surgery i.e. manipulating instruments under endoscopic guidance. This second learning phase is generally carried out on a human cadaver or an animal.
To overcome the length and complexity of this learning, solutions have been developed in an attempt to reduce the learning curve for practitioners so that they may soon become operational.
U.S. Pat. No. 5,791,907 can be cited which proposes a learning device for training in surgery protocols for surgical operations including under endoscopy. This device comprises a screen which displays a partial sequence of a surgical procedure i.e. a succession of surgical steps; once this sequence has been viewed, the user must input data to characterize the following surgical step in the procedure, by indicating for example which instrument is to be used, in which position, etc. Nonetheless, said device does not provide for improvement in the practical learning phase which is the most complex and above all the longest.
To improve this practical learning phase, simulators have been proposed to place the practitioner under real conditions. These simulation devices are of interest since they can shorten the learning step on cadavers or animals. However, they do not truly bring acceleration of the practitioner's practical learning phase.
Despite these new learning tools, learning will never be perfect. Practitioners gain much more experience during their first real operations under endoscopy. It is estimated for example that a surgeon must operate on a hundred or so patients before being fully efficient for a radical prostatectomy via endoscopic route. This implies that the practitioner may make surgical errors during initial operations. These errors may have consequences such that it is necessary to complete the operation under open surgery, which has consequences for the patient and for the hospital. In addition, this may lead to less effective management of the disease (higher percentages of margins of resection during the learning period, longer operating times, increased morbidity rates) which has functional and carcinological consequences for the patient, and also financial consequences not only for the hospital but also more generally for society as a whole.
One purpose of the present invention is to propose an analysis method and system for surgical operations via endoscopy with which to solve at least one of the above-cited disadvantages.
In particular, one purpose of the present invention is to propose a method and system allowing a practitioner to rectify any errors during a surgical operation before there are any irreversible consequences for the endoscopic operation in progress.
Another purpose of the present invention is to propose a method and system offering practitioners the possibility to analyze retrospectively the conducting of any of their surgical operations via endoscopy.